Major advances in the treatment of human immunodeficiency virus (HIV) infection have recently been made. Highly active antiretroviral therapy (HAART) has made it possible to reduce the quantity of plasma HIV-1 RNA to levels below the detection limits of currently available assays. However, for optimum and persistent viral load reduction, patients are required to adhere to complex drug regimens. Suboptimal adherence to HAART may result in viral load increases and the emergence of drug- resistant strains of HIV-1. Long-term effectiveness of these drugs will not be possible if viral resistance occurs. We postulate that a good understanding of the rationale of HAART and the risks and consequences of viral resistance from medication nonadherence are essential incentives to encourage adherence to these tedious regimens. Patient education is a crucial part of the management of HIV infection. Educational efforts may be augmented by using validated instruments to assess HIV-related knowledge. The objective of this study is to develop and validate a questionnaire for use in HIV- infected individuals to assess their knowledge of HIV infection and its drug therapy. Such an instrument would enable health educators to determine a patients baseline knowledge and develop a patient-specific plan for education. The HIV Knowledge Questionnaire (HKQ) consists of two sections (drug therapy and disease state) of multiple-choice questions. In order to evaluate the ability of the HKQ to differentiate between individuals with varying degrees of HIV-related knowledge, each section of the HKQ has been administered to two groups of non HIV-infected individuals consisting of medical experts and individuals with limited HIV-related knowledge. To date, 27 medical experts and 185 individuals with limited HIV-related knowledge have completed the HKQ. Data analysis will begin when the required number of individuals have completed the HKQ (47 experts, 192 individuals with limited HIV-related knowledge). Result: The ultimate goal of this project is to utilize the questionnaire as a tool to assess patients understanding of their disease state and drug therapy. Numerous studies have shown that drug adherence is a key to maximal and sustained virologic response to HAART regimen. It has also been shown that patient knowledge regarding the role of HAART, the importance of good adher-ence, and anticipated side effects of these agents are essential elements for drug adherence. Thus, it is intuitive that there can be a correlation between knowledge in HIV infection and therapy and viro-logic response. After the validation of this questionnaire, we plan to utilize this instrument in HIV clinics to further assess this hypothesis. The instrument can also be used as a tool to identify areas in which individual patients may benefit from more extensive education. This study is terminated.